Determinants of Health
Wednesday, November 28th, 2007While it is going to be ” personal perspectives” that help quantify or rate the importance of the determinants of health, I give you a list to consider the relevance of these particular issues at this time in history.
AGE- the very youngest and the very oldest of our society are very vulnerable…for one major reason, their voice is always spoken by someone else, inclusive of that “someone else’s” agenda.
POVERTY- this is inclusive of the quality of life possible in developed countries and even more critical as we examine the lack of essential food, clean water and often even shelter, for those identified as refugee’s.
PEACE- the daily news from many media sources is illuminating the struggles of societies and the world at large over the issue of peace and civility through-out Africa, the Middle East, Parts of Asia and South America. Even the threat of Nuclear armamant, the return of a Cold War…the fear and anxiety that prevails is a very big threat to Health in all its Domains.
HEALTH SERVICES ORIENTATION- This is a much bigger issue than is publicized or even conceptualized among lay persons and professionals alike. Maintaining a status quo, of promotion of “cure” has been “profitized” and promotes exploitation and disparity. The exploitation of the “Pink Ribbon” phenomenon, stands as one example. BIG PHARMA lobbying for research dollars on one hand while lobbying for the denial of affordable generic drugs (in particular for AIDS in Africa) stand as a Legacy…on that should be a “cloak of shame” for industry”…one that is attached to the health , well-being and quality of life of the human species. The insistence of perpetuation of power and control of Medicine practitioners over the public and all other Professions related to healthy living, Healthy Families and Healthy Communities, is also a shameful, unethical stance.
LITERACY- Without question, those that can read, comprehend and act on one’s own behave with information and knowledge of dangers, risks, threats to health…and all other components of healthy living and self-care…will always be hugely disadvantaged…and in many cases, exploited by others while much less likely to achieve optimal health, well-being or quality of life.
The GENDER equation- there are now two sides to this coin. For millenia, it has been a disadvantage to be a woman. Many nations and societies in the world continues to disadvantage women through religious practices, denial of education, and victimization and exploitation. Enslavement, rape associated with lawlessness and/or war…is still a harsh reality for some. Social Justice mandates action toward positive change. Gender bias has been long established regarding treatment and response in health care. Research based on men, to this day, supports treatment for women for many differing conditions. The DSM-IV is a hugely flawed system, and continues to perpetuate gender-based stigmatization, stereotyping, mis-guided treatment and empowers a huge male cohort of Powerful Professionals with control and “authority” over dis-empowered and victimized groups. Historically, Post-Traumatic Stress Disorder
On the other hand the historical “feminization” of Nursing has led to one profession being hugely dominating one gender over another, with a legacy that includes exclusion of males from the profession, and remains, as a “discretion” of a largely female faculty. Further, there has been the perpetuation of “Nursing Theory” in which the male perspective has been absent. The list of “who’s Who” amongst nursing theorists, will demonstrate this huge disparity and gender gap. With funding towards equality issues such as Nurse Practitioner services and/or Nurse-led-clinics, any critical examination will reveal significant emphasis on the value of womens health specialization (which is a valued social justice initiative) while at the same time…there is little evidence that “Men’s Health” is being valued or perpetuated within the domains of Nursing or evolution of nursing roles.
ENVIRONMENTS- This can be viewed under an “ecological lens” as well as one that is a “contained: environment such as the workplace, as much as it could be a “conceptual” environment, referring largely to workplace cultural environments. Workplace safety is an ongoing issue and challenge. Workplace violence and exploitation is still under “the radar” as we examine Healthy Workplaces.
On very tragic, unfortunate, yet valuable “Case Study” regarding Workplace Culture will be ever immortalized by the tragic death of Nurse Lori Dupont. Being that it was a “health care environment” makes it that more valuable to put examined under a critical lens. Harrassment, Aggression, Bullying, Horizontal Violence, exploitation, threat, extortion and defamation of character are all illuminated by one such tragic case, in which we hope many valuable lessons will be learned. This also stands as a reasonable evaluation of the previous Gender and Power issues that have also been discussed.
POWER, OPPRESSION, COMPETITION, DISCRIMINATION, EXPLOITATION- All closely related and collectively is a reality for many. These influences will cross-over collectively or as separate issues for many other determinants of health. A civil and just society will examine theses issues for the deterents to health and quality of life for the masses, in which they represent. The sheer complexity and interactions with so man other consideration, is beyond the scope of this summary provided here.